Jobs in United States of America

Job Description: Validate the accuracy of claim billing, reviewing complex claims and coding,. The Medical Nurse Auditor conducts reviews of medical records, financial…

Job Description: Maintain current knowledge of coding applications for ICD-10 and other applicable coding standards that apply to medical claims.

Job Description: Processes claims for unemployment compensation benefits, when workload demands, in order to relieve a backlog in the Benefit Adjudication Unit, and to ensure…

Job Description: Support the claims team in implementing initiatives in improving claims processing efficiency. Conducts pre and post payment adjudication audits of claims and…

Job Description: You will be responsible for monthly random and focus audits of all claim processing activities to identify inaccurate claims adjudication.

Job Description: The ideal candidate has a Certified Professional Coder or Certified Professional Medical Auditor certification and has either worked as a medical claims auditor…

Job Description: Prebilling/billing and follow up activity on open insurance claims exercising revenue cycle knowledge (ie;CPT,ICD-10 and HCPCS, NDC, revenue codes and medical…

Job Description: Certification as a professional medical auditor is preferred. Compile medical audit results and provide the Business Office Director monthly reports.

Job Description: Proficient/functional knowledge of electronic medical record systems and information technology. Quality Auditor is also involved in the clinical denial/appeal…

Job Description: Experience in medical records review, claims processing or utilization/case management in a hospital, clinical practice or managed care organization.

Job Description: Basic knowledge of medical claims. Prior coding or medical claims experience or training. Ensure that all invoicing for medical records, itemized bills and…

Job Description: Plan and perform medical record audits to determine coding accuracy and compliant claims submission; This specific position will require knowledge of medical…

Job Description: Processes claims in a timely and accurate manner by meeting or exceeding established quality and production standards, utilizing reference materials;…

Job Description: Refer large-dollar claims and trigger diagnosis to preliminary claims and case management departments. Set claims reserves and adjusts as needed.

Job Description: Validate the accuracy of claim billing, reviewing complex claims and coding,. The Medical Nurse Auditor conducts reviews of medical records, financial…

Job Description: Experience working with medical claims platforms. Working knowledge of medical terminology and claim coding. Position in this function investigates Optum Waste…

Job Description: At least three years of direct experience in coding/auditing outpatient services, and medical chart review for all provider/claim types for outpatient facility.

Job Description: Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis. May also settle insurance claims.

Job Description: We are seeking a talented individual for a Supervisor, Clinical Claim Review who is responsible for supervising the day-to-day prepay, post-pay, and utilization…

Job Description: The primary use of Dash Cams is to assist in the protection and safety of employees and property, prevention, and detection of criminal offenses such as vehicle…

Job Description: Job Summary: The Coding Auditor is responsible for the overread of documentation and coding of medical records at various partnered medical practices.

Job Description: The role of the auditor is to educate providers performing services in clinic base and hospital setting in ensuring documentation meets the reporting…

Job Description: Reviews, audits medical claims submitted by non-plan providers to ensure accuracy and appropriateness of charges submitted. Follows up on referral compliance.

Job Description: Knowledge of compliance regulations applicable to health organizations, claims administration and ERISA is highly preferred.

Job Description: Included are processes related to enrollment and billing and claims processing, as well as customer service written and verbal inquiries.